Immunomodulatory therapies for sepsis: unexpected effects with macrolides

International Journal of Antimicrobial Agents
Evangelos J Giamarellos-Bourboulis

Abstract

Despite intensive efforts to increase our knowledge of the inflammatory pathways involved in the pathogenesis of sepsis, several clinical trials of agents aimed at modulating the immune response of the host, such as anti-endotoxin antibodies, anti-tumour necrosis factor (TNF) antibodies and soluble TNF receptors, have failed to disclose any definite clinical benefit. The same applies to the administration of low-dose hydrocortisone as well as intense glucose control by continuous insulin infusion. Macrolides are a traditional class of antimicrobials proven to act as modulators of the host's response in chronic lung disorders such as diffuse panbronchiolitis and cystic fibrosis. The favourable outcome of community-acquired pneumonia treated with the combination of a beta-lactam and a macrolide is partly attributed to their immunomodulatory properties. Based on favourable responses to intravenous administration of clarithromycin in experimental models of sepsis by susceptible and multidrug-resistant Gram-negative isolates, a randomised clinical trial was conducted in 200 patients with ventilator-associated pneumonia (VAP) and sepsis (http://www.clinicaltrials.gov; NCT00297674). Clarithromycin was administered at a dose of 1g with...Continue Reading

Associated Clinical Trials

References

Mar 10, 2001·The New England Journal of Medicine·G R BernardUNKNOWN Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study group
Mar 27, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jean-Louis VincentMarc-Jacques Dubois
Aug 21, 2002·JAMA : the Journal of the American Medical Association·Djillali AnnaneEric Bellissant
Jan 10, 2003·The New England Journal of Medicine·Richard S Hotchkiss, Irene E Karl
Feb 5, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·José A MartínezJosep Mensa
Mar 29, 2003·Intensive Care Medicine·Mitchell M LevyUNKNOWN International Sepsis Definitions Conference
Apr 12, 2003·Critical Care Medicine·Mitchell M LevyUNKNOWN SCCM/ESICM/ACCP/ATS/SIS
Dec 25, 2003·Antimicrobial Agents and Chemotherapy·Evangelos J Giamarellos-BourboulisHelen Giamarellou
Jan 25, 2005·International Journal of Antimicrobial Agents·Evangelos J Giamarellos-BourboulisHelen Giamarellou
Mar 15, 2005·Scandinavian Journal of Infectious Diseases·Evangelos Giamarellos-BourboulisHelen Giamarellou
Mar 23, 2005·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·E García VázquezA Torres
Sep 30, 2005·The New England Journal of Medicine·Edward AbrahamUNKNOWN Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis (ADDRESS) Study Group
Mar 22, 2006·The Journal of Antimicrobial Chemotherapy·Evangelos J Giamarellos-BourboulisHelen Giamarellou
Feb 27, 2007·Intensive Care Medicine·Christoph EngelKonrad Reinhart
Oct 16, 2007·International Journal of Antimicrobial Agents·Evangelos J Giamarellos-Bourboulis
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
Jan 11, 2008·The New England Journal of Medicine·Charles L SprungUNKNOWN CORTICUS Study Group
Jan 11, 2008·The New England Journal of Medicine·Frank M BrunkhorstUNKNOWN German Competence Network Sepsis (SepNet)
May 1, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Evangelos J Giamarellos-BourboulisHelen Giamarellou

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Citations

Dec 25, 2009·Rheumatology International·Gianantonio SaviolaGiuseppe Cirino
Feb 6, 2010·Critical Care Medicine·Greet HermansGreet Van den Berghe
Feb 6, 2013·Antimicrobial Agents and Chemotherapy·Kentaro NagaokaShigeru Kohno
Dec 23, 2010·Immunotherapy·Anastasia Antonopoulou, Evangelos J Giamarellos-Bourboulis
Jan 1, 2009·Aging Health·John E StupkaMarcos I Restrepo
Jul 1, 2010·Expert Review of Clinical Pharmacology·Jijie Gu, Tariq Ghayur
Jan 21, 2016·Expert Review of Respiratory Medicine·Jordi Rello, Antonio Perez
Jan 25, 2016·Journal of Critical Care·Majid AfsharEllen L Burnham
Jul 9, 2013·Critical Care Clinics·Wendy I Sligl, Thomas J Marrie
Jun 26, 2012·European Journal of Internal Medicine·Jose Manuel PereiraJordi Rello
Apr 21, 2012·Survey of Ophthalmology·Ramana S MoorthyNarsing A Rao
Aug 12, 2009·Infectious Disease Clinics of North America·Marcos I Restrepo, Antonio Anzueto
Sep 17, 2015·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·JoonHo LeeBo Hyun Yoon
Dec 17, 2014·Scientific Reports·F RatzingerK G Schmetterer
Jul 16, 2010·Mediators of Inflammation·Bolin CaiLuis Ulloa
Jan 8, 2013·The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases·José Bruno Nunes Ferreira da SilvaTeresinha Gonçalves Silva
May 6, 2014·Frontiers in Microbiology·Francesco ImperiPaolo Visca
Mar 8, 2011·Therapeutic Advances in Respiratory Disease·Ilya Berim, Sanjay Sethi
Mar 22, 2013·American Journal of Physiology. Renal Physiology·Vanesa D Ramseyer, Jeffrey L Garvin
Jul 3, 2015·Physiological Reviews·O FriedrichL Larsson
Aug 29, 2016·Critical Care : the Official Journal of the Critical Care Forum·Jason PhuaTow Keang Lim
Sep 4, 2015·American Journal of Clinical Dermatology·Harald-Morten CurthHans-Michael Steffen

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